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Reports: Trump to sign executive order to overhaul ACA rules

Oct. 12 (UPI) — President Donald Trump will take the issue of healthcare directly to the White House Thursday by signing an executive order to overhaul certain rules in the Affordable Care Act, sources say.

After months of dealing with Congress’ failure to repeal and replace the ACA, Trump is expected to sign an executive order on Thursday aimed at easing rules on small businesses joining together to buy health insurance known as association plans, Politico reported, citing officials with knowledge of the plans.

The order will place limits on short-term health insurance plans, they said, and encourage cheaper and more loosely regulated health plans aimed at younger, healthier people. By allowing healthier people to seek coverage elsewhere, experts say that could leave less healthy participants on the hook for the difference.

One of the primary concerns is for the stability of the insurance marketplace, which has declined in recent years since the ACA was introduced as more insurers have opted out. If healthier people switch to more affordable non-ACA plans, experts worry, sicker people could be left to deal with increasing costs.

“Within a year, this would kill the market,” Karen Pollitz, who worked for former President Barack Obama‘s Health and Human Services Department, said.

The Trump administration might also go so far as to reimagine the Employee Retirement Income Security Act, also known as ERISA, by reinterpreting a workplace rule to broaden the types of groups that can qualify as associations, Politico’s report said.

The new association definition could cover small businesses, trade groups, unions and self-employed individuals. Associations wouldn’t have to meet ACA benefit requirements or cover a minimum percentage of employee healthcare costs.

With associations, health care providers can effectively choose the most desirable participants, allowing for the healthy to make the switch over.

“No one healthy is now going to sign up in the ACA risk pool, because they have this cheaper option,” Deep Banerjee, a health care analyst at S&P Global Ratings said.

The Hill reported that Sen. Rand Paul is expected to be in attendance at the unveiling of the executive order on Thursday after pushing for this order for months, arguing that allowing small businesses to band together to buy insurance gives them leverage to lower premiums.

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